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tv   Face the Nation  CBS  March 13, 2017 2:00am-2:31am PDT

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>> dickerson: welcome back to "face the nation". i am john dickerson. among the biggest criticisms of the debate so far on healthcare is that it has happened without an official accounting from the congressional budget of course or cbo. among the big questions that remain unanswered about the republican healthcare bill, how much will it cost and how many people might lose coverage if enacted in its current form? we ask speaker ryan why the house started work on the bill without this information. >> the score we believe will come out probably monday or tuesday. well before we go to the floor. well before we go to the floor we will have the score. the one thing i am certain will happen is cbo will say, well gosh not as many people will get coverage why you know why? because this is not a government mandate, this is not the government say you should buy what we think you should buy and you need to buy it. there is no way you can compete
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with on paper a government mandate with coverage. what we are trying to achieve here is bringing down the cost of care, bringing down the cost of insurance, not through government mandates and monopoly, but by having more choice and competition and by lowering the cost of healthcare, you improve the access to healthcare and by having the things that we are talking about, tax credits, risk pools, health savings accounts you increase the access to healthcare, we are not going to make an american do what you don't want to do, you get it if you want it, that is freedom. >> dickerson: how many people are going to lose coverage under this? >> i can't answer that. it is up to people. hoo search the premise of your question. are you going to stop mandating people buying health insurance? people are going to do what they want to do with their lives and we believe in individual freedom in this country, so the question is, are we providing a system where people have access to health insurance if they choose to do so? and the answer is yes. but are we going to have some nice looking spreadsheet that says we, the government of the united states are going to make people buy something, therefore
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they are all going to buy it? no. that is the conceit of obamacare in the first place. so it is not our job to make people do something a that they don't want to do. it is our job to have a system where people can get universal access to affordable coverage if they choose to do so or not. that's what we are going to be accomplishing. >> dickerson: but there have been promises made, president trump ran on this and you have talked about how promises you make in your campaign set the table for things you are going to do. they has promised everyone will be covered. can he -- rogers says, quote no one who has coverage because of obamacare today will lose that coverage. >> that is talking about the transition. i can't talk about what secretary cathy -- we don't want to pull the rug out from under people. this is what i am concerned that some people in america are thinking, the day we pass this bill, the day after, they are going to lose their coverage. that is just not the case. >> dickerson: some are concerned they might lose it in two months. >> they won't in two months either or two months later. the point we are trying to make there will be a smooth transition, a stable transition
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so that people who are covered today don't have the rug pulled out from under them but let's remember where we are when we started this conversation, the system is collapsing. 160 percent in premiums in arizona alone, five states, one plan, over 1,000 counties, one plan dash. >> because there are lots of people -- >> dickerson: are you saying the premiums -- >> far, far hires higher than they would otherwise go. >> you think they will go up. >> less than -- >> look at the bill, in two years, that's the point, there is a transition, it takes a little while to get the states back in the gauge to regulate health insurance and it takes a little while for risk pools to be set up in the states to cover people with preexisting conditions, it takes a little while for tax credits to be deployed so that the guy waiting tables and getting $12 an hour can get health insurance. it takes some time to do that. and in the meantime, there will be a stable transition so people don't have the rug pulled out from under them. that's what we are talking about when we say a stable transition from the system that is creeing
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and collapsing to one that is better and more endurable. >> dickerson: why not in just plain terms, rug pulled out from under them. >> let's say if you are under obamacare and be covered you will still be covered nonprofit insurance companies are pulling out of markets left and right. the government didn't control the decision humana made which is i am pulling out of this market and therefore tennessee and counties of tennessee don't have health insurance. that's not a promise a politician can keep because it is outside of that person. >> dickerson: that's the old promise. there is a new bill with a new promise and the president said seven going to get covered. >> obama area is crashing. >> #02: i get that. >> but you can't say, that is the actual reason -- you do nothing, there is going to be even bigger premium increases next year and even more pullouts -- >> we can't promise -- is going to happen. what we can promise is we are going to replace wit a better system so we have more insurers and more choices and more competition, prices go down and we give people the ability to go access, to access affordable
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coverage. >> dickerson: if i a am getting coverage through the individual market now i am nervous. there have been a lot of changes you are talking and saying it is all going to work out wonderfully but it is a theory about how markets will work and the competition. >> it is something you believe in passionately. >> it is not just a system i believe in passionately but has worked well. in healthcare -- >> when you increase choice and you increase competition, you bring more players to the marketplace who compete against each other for our business. well we never had in the individual market is equal tax treatment so that a person who doesn't get healthcare from their job but is out there working gets a tax benefit to go buy health insurance. that is what health savings accounts and tax credits are. risk pools work very, very well we had them in wisconsin, it was i think the best way of the getting the em with preexisting conditions affordable coverage, obamacare destroyed that system. obamacare federal lied the entire system and blew up the american healthcare system, so it is going to take us more than
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a few months to stop that damage and replace wit a better system. >> dickerson: let me ask you a question about that. the tax credits in the bill you have gotten a lot of criticism from conservatives who the freedom works called this an individual mandate by another name and the individual mandate, that part of obamacare they don't like. the republican study group said that this credit is, in principle, obamacare. so why are they wrong? >> i think they are wrong because this has been longstanding conservative reform for decades -- >> dickerson: individual mandate -- -- >> tax credits, so look, here is what we always said as conservatives, which is we should equalize the tax treatment of healthcare, everybody who gets healthcare for the job gets -- so the only way to make sure that working poor person, that working low and middle income person can actually get something off of their a taxes is through a tax
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credit. we think equalizing the tax treatment of healthcare, giving people more freedom in the individual market is the best way to replace obamacare with a patient centered system so it has been longstanding conservative reforms that we do this. and it is frustrating some conservatives are now changing their tune and mischaracterizing these things? of course it is. but that is how the legislative process works. >> dickerson: in medicaid you have got conservatives saying that you are phased out of the expansion, it is happening too slowly, with en20 the target date is too slow and republicans in the senate saying it is happening too past, the poor and mentally ill will be hurt. >> so we are probably right in the sweet spot. i think what happened -- >> is it going to stick in? it going to move. >> this is a carefully balanced consensus among all of the republicans in consultation with the governors of how to somewhere a smooth transition as we get medicaid back to the states. the concern about ending the, ending the medicaid and changing medicaid too soon there will be a gap in coverage before the tax credits kick in and so that is a concern about doing this too soon. here is what i would say -- this
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is what i say when i say people are losing the forest for the trees. we are sending medicaid on a per capita da to the state and capping its growth rate. this is the most historic giement re, entitlement reform we ever had. this? bigger than -- reform in 1996. so if the transition takes three years or two years, that is missing the forest through the trees. so that is the point i keep trying to make which, is look at the totality of this and look at the historic a achievement this is and i think this at the end of the day is going to win this argument among people on my side of the aisle. >> dickerson: all right, mr. speaker, thanks so much with being with us. >> you bet, thank you, john. >> dickerson: we will be right back with our political panel. don't go away. >>
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lakshmanan,. >> dickerson: and we are back with our political panel. avik roy is the president of the foundation for research on equal opportunity. and political advisor for mitt romney and marco rubio. and we welcome indira lakshmanan of the boston globe, indira has also been named the new chair of journalism ethics at the pointer institution and chief white house correspondent for "the new york times" peter baker is with us, peter baker i will start with you. give us your assessment of where things stand after the first week of the rollout of the alternative to the affordable care act. >> well, earlier in your program you got the left and right, very different critiques of this plan
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and a president who isn't quite sure which way forward. he is said contracting, in fact, the policy to paul ryan, which as you demonstrated, very smart -- master of the subject, but i think the question is, what investment is he going to tut into the path of this bill. he doesn't really care, think about some of the specific details, what he wants is a winner, he says you have to have a win and a something he can wall call repeal and replace. whether this is, whether it is or not is unclear. policy -- -- and so we are waiting to hear from the president. and. >> dickerson: what do you make of the legislation put forward by paul ryan? is it the best he can get? >> well, i think he tried to split the difference between the people, pragmatic republicans who want to make sure that the replacement is competitive with the aca on covering the uninsured and the people like rand paul who say that anything that attempts to provide
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financial assistance to the uninsured, is obamacare light and i thought your interview with him today was really interesting because rand paul in 2012 introduced a bill to provide private coverage to seniors as an alternative to medicare, it would be heavily subsidized with richer benefits than medicare and protect people against preexisting conditions, require insurers to charge the same prices to the healthy and the system sick and cap out-of-pocket costs and lips. all things theoretically that are unique for obamacare, will se for obamacare light when it comes to seniors not when it comes to the uninsured, and i think this is operationally the challenge republicans have. they say they are a normative, they are against subsidies, the federal government's involvement, and what they are operationally against is assistance for the uninsured and the low-income populations, for republican voters, the older, the employed, they are totally in favor of, and comfortable with subsidizing coverage. >> dickerson: how, ezra how do you see the winners and lose in other words this bill?
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>> in is a bad bill and that's why it received a very bad reception and i am sorry i can't be more positive than that. it is, you have a $6 billion tax cut and loring in subsidies for people and betraying promise after promise made by donald trump and mitch mcconnell, he promised no cuts to medicaid this is a sharp, sharp cut to medicaid, mitch mcconnell, right here on this program said the problem with obamacare is the deductibles are too high, the cophase are too high, people are buying insurance and can't afford to use it. the way this bill works is you push people into insurance when they could afford it that have higher deductibles and higher copays. they seem to have defined the problem extremely narrowly. pass something, anything we can call appeal and replace of obamacare but when they actually try to put this into law, which in the bill, it is shoddy in construction and not waiting long enough to even figure out how to amen amend it if you tryo put it in law it will create skyrocketing premiums, a lot
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less competition and they are saying you don't have enough competition, and about 10 million people, depending on which estimate you look at, will lose insurance. i don't know who they think is going to be happy with that. >> adverse selection meaning healthy stay out and to the sick stay in and it is going to be too expensive? >> one big constraint that republicans have is because they are insisting on doing this in a party line approach, using the senate reconciliation process. >> dickerson: where you only need a majority instead of 60 votes? >> right. the problem there is you can address the reconciliation process but not doing anything about regulation and so much of the affordable care act is regulation, all the complaints that paul ryan made in your sphwhiewf about rising premiums, those are driven by regulations and if you can't reform those regulations through this bill you are not actually solving the problems you think that obamacare -- >> dickerson: and that's why you say it is a multistage approach but the fact is everybody is focused on the first stage and not the second and third. indira what do you make, if president trump were watching this discussion, it would sound like a lot of noise probably to
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him. >> that's right. >> dickerson:. >> >> dickerson: he is a -- >> that's what i was going to say, john. i think we will need to look at this also from a political point of view, it is great to hear all of the details of the plan, but president trump sold himself on the campaign trail as a deal maker in chief. he said to the american people, i am going to be able to get you a better deal. i am going to be able to fix health care because i am going to be able to negotiate better drug prices. i am going to be able to a negotiate better with the healthcare company. i am going to be able to do everything better thch is his first big test. he is coming to washington. i don't think he cares so much about the details. that's what we talked about. the he subcontracted this out to speaker ryan and said you do it, that's okay. we know we have to repeal and replace all in one step so just do it. that's fine. now he is going to have to go out to kentucky, he is going to have to go out to tennessee, se going to do the salesmanship. he has people coming, he has members of congress coming to his bowling alley in the white house and by all accounts he is making friends, influencing people, even senator lindsey graham who is no big fan of donald trump, i
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was amazed to hear his interview yesterday coming out of the white house, well i had a pretty good time, boy she a charming guy and at the same time, donald trump is putting pressure on the republicans saying it is going to be a bloodbath in 2018 if you don't pass this. >> dickerson: and paul ryan is also saying with everything else, can only come tax reform, all the things they want to pass can only happen if this happens. peter s is the big hurdle for donald trump, the fact he said everyone is going to be covered and we have estimates of 10 million, maybe 15 million, the cbo official accounting may be quite bad. is that a big thing that had that the president will have the biggest problem reconciling. >> as you pointed out in the interview, they found so many things that seem untenable if you put them together into a plan, unless you are spending lots of money and doing things in a different way than paul ryan wants to do them, and ultimately you can't rule out some of those certain expectations he created and with the voters, the striking thing is some of the people who are probably most affected by some of the changes we are talking
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about here, the less wealthy, rural white, working class americans who love donald trump, who voted for him, who put him into office, and he owes them and he wants to keep them on his side. so it is going to be tricky. >> dickerson: we will return with this geometry and take a break here quickly and then we will come back and continue this conversation. stick with us. >> ,,,,,,,,,,
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>> dickerson: and we are back with more of our panel. easy remarks i am going to ask you a question about something bernie sanders said about the tax cuts for windfall he says is going to the top one percent. remind people why we are talking about tax cuts and why this is a part of healthcare. >> well, you have to fund the aca coverage expansion so in the back of the envelope basis over a ten year period, if he spends $2 trillion trying to cover the uninsured and fund that through about 1.2 trillion in tax increases and about $850 billion in medicare cuts, and what the house republican bill does it actually preserves the medicare cuts in the aca because you can't touch medicare through reconciliation, but they repeal
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nearly all of the tax hikes, and then have their own coverage ex-paption in the new structure you talked about with paul ryan. >> it is one of the,. >> is one of the challenges here there has been habit of a success for the affordable care act, obamacare which is that it created expectations that you are going to cover preexisting conditions and coverage requires requirements and then also dash and if you keep those, those which this does it makes it more expensive. >> it makes it expensive but also means you are working in the main broad frame of obamacare if you are doing that you have to maintain important parts of that framework. they are splitting the difference between so many different arguments they have stopped being able to make sense of any of them in particular. so you are trying to take out the individual mandate, replace it with something that is not quite an individual mandate. this 30 percent surcharge on healthcare when you come back to the market. and all of a sudden it doesn't work quite as well but it makes people angry and not sure what goal they are trying to achieve. at this point about
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reconciliation, which is brought up is a really important one. i was stunned, actually to hear paul ryan on the program earlier today say that the -- was jammed down the country's throat with this. this is a regular -- slow process. we didn't see this bill until last monday. this is the first time we have seen it and i saw the stuff ryan produced before. this is all different. this is the first time virtual seen this legislation with this i don't know sell population of ideas there is no independent analysis of it and it passed two committees on how it worked and a what it would do. and without going through this process of information and amendments and go back and forth and decide if it is going to work, there has not been time for republicans or really for anybody to access the fundamental questions and decide, do we need to change a this bill in a pretty fundamental ways. >> the speed they are trying to do there is a speed of fear, the speed that is going to make bad policies. >> dickerson: that's when i asked him about you can say you ran on this but you didn't run on the particulars that are being debated. one things that strikes me this
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white house doesn't really have a bunch of old legislative hands. usually the white house who had people who worked on the hill on how to figure in stuff out, so this is kind of an operational challenge for them over there. >> that's right. and as a comparison, you know, the republicans of course were saying that the obama administration shoved healthcare down the throats of the american people, but, in fact, it was 15 months that there was open debate over the affordable care act. >> they want to do it in one month and 15 months is a huge difference, where everybody was looking at it, debating it, talking about it, so that is a very important difference. and you make a point, it is operationally different. if you don't have the expert on, you know, the liaisons with the legislature, then you don't really know how to do it, but we see than in so many ways, it is kind of akin to putting in charge of cabinets, you know, putting cabinet secretaries in charge a of agencies that those people want to abolish those agencies so it is kind of a similar thing, that, you know, it is the sort of disruptive
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factor in government. >> what is going to be interesting is when that congressional budget office score comes out for this bill, and it says something like the bill will cover 20 million fewer people than the affordable care act, does donald trump, does the president who has promised insurance for everybody say the cbo is fake news? does he say republicans go back to work and fix this? because there are -- the cbo really, really believes in the individual mandate much more so than the insurers do, so maybe part of the cbo report that are uncharitable and perhaps you can dispute but there are aspects of the bill that are going to result in fewer people having health insurance and it is going to be interesting to see how the president himself reacts to that. >> dickerson: they have already started lowering the view of cbo in the white house briefing, trying to maybe, anticipating a bad ruling. >> let me ask you a question, peter about another piece of news which is the travel ban the president changed this week. there wasn't as much coverage as the first one. how did it change? >> well, there is an important difference -- in this war against isis, what it did is it
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made clear and explicit that green card holders and people that have visas already are not included, and took out a preference meant for christians, minorities in some of these countries so those are important in, and minimizes some of the disruption we saw the first time, you didn't have people on airplanes literally blocked at the border when they got here. beyond that, it is still pretty similar. it is still stopping all refugees and all of the muslim majority countries. now, you are now back in court and have lawsuits already and i think the issue is going to be, the courts will look as this as a dressed up version of the same thing or there are substantive changes, that are constitutional. >> they did reverse engineer this second travel ban in a way. it is clear from looking at it, i spoke to many legal scholars about this, that the trump administration kind of looked at the bill, looked at what the complaints were from the judges,
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from the ninth circuit court of appeals and sort of created the new travel ban kind of backwards from that. so a lot of legal scholars think this will, you know, stand up in court, although there are a lot of problems that predate anything that is written down which is that donald trump himself said on the campaign trail back in december 2015 i want a muslim ban, keep them all out so there are so many things he said in the public record that courts can look at, they can say hey this is really a muslim ban dressed up as something else, so that sort of irrespective on the what is on the piece of paper. >> dickerson: ezra can i get a last thought on you from the job numbers on friday. the president took credit for the strong february. put that in context. it has to be a relatively brief context. >> i don't think he got credit for it because we are in the context of a long running market expansion. they are good job numbers, he has not done anything yet to interrupt them and presidents can do a lot of things to mess up a good economy so right now we should be thankful, we are
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seeing wages go up, that is good and we should be careful to try to preserve it. >> dickerson: all right, thanks all of you for being here. thanks for watching and we will be back in a moment. >> when you wanna put allergies with nasal congestion on notice, find fast, all-day sweet relief behind the pharmacy counter with claritin-d. [ upbeat music ] strut right on past that aisle... ...and tell your stuffed up nose to stuff it, with claritin-d. a non-drowsy allergy medicine combined with the best oral decongestant. it starts working in as little as 30 minutes.
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>> dickerson: that's it for us today. i will see you tomorrow when we welcome back our friend and colleague charlie rose on cbs this morning. until next week, from "face the nation", i am john dickerson. captioning sponsored by cbs captioned by media access group at wgbh access.wgbh.org ,,,,,,,,,,
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